What you need to know about the diaphragm

A diaphragm is a reusable, flexible cup that you insert before sex. It sits over your cervix and acts as a barrier, stopping sperm from reaching the womb (uterus). It’s used with spermicide gel, which kills any sperm that comes into contact with it. You insert the diaphragm yourself, at a convenient time before sex. And it’s reusable for up to 2 years.

There’s currently only one type of diaphragm available in the UK, called Caya. This may change in the future.

Likelihood of getting pregnant over 1 year

Used perfectly, the diaphragm is 94% effective against pregnancy. But none of us is perfect and it's more usual that people will forget their diaphragm sometimes, or not follow the instructions exactly. So, with more normal use it’s 88% effective.

This means about 12 in 100 people using the diaphragm will get pregnant in 1 year.

The diaphragm is a good choice for anyone who wants a non-hormonal method. It’s ready when you need and doesn’t interrupt sex. But it’s not as effective as other methods. If you really do not want to risk pregnancy, you might consider more effective alternatives.

Dr Paula Baraitser. Medical Director, SH:24

Using diaphragms to prevent pregnancy

You’ll need to get used to putting in your diaphragm. It’s a good idea to practice this before the first time you use it during sex.

You need to use a spermicide gel with the diaphragm each time you use it. You can get this from a pharmacy, or your local sexual health clinic.

You can insert a diaphragm at a convenient time, up to 3 hours before sex. Or you can put it in immediately before. If it’s in for longer than 3 hours, you’ll need to take it out and put more spermicide on it, or use an applicator to apply more spermicide.

After sex, the diaphragm must stay in place for at least 6 hours. You can have sex again before taking it out, but add more spermicide before you do. You can leave it in for longer than 6 hours, but not longer than 24 hours.

Diaphragms are a good option if you…

  • don’t want to, or aren’t able to use hormonal contraception

  • want contraception that does not affect your periods

  • are looking for a reusable and environmentally-friendly method

  • want a barrier method that does not interrupt sex

  • don’t want to think about contraception every day

They’re not recommended if you…

  • cannot reach your cervix, it might be hard for you to get the diaphragm in the right place

  • have weakened vaginal muscles that cannot hold a diaphragm in place

  • gave birth less than 6 weeks ago

  • have a sensitivity or an allergy to the chemicals in spermicide

  • have ever had toxic shock syndrome, a very rare but serious bacterial infection

  • have repeated infections of the urinary system, such as the urethra, bladder or kidneys (urinary tract infections or cystitis)

  • are not comfortable touching your vagina

  • are at higher risk getting an STI – for example if you have multiple sexual partners

How to avoid the diaphragm becoming less effective

  • check your diaphragm regularly for tears, holes or other signs of wear

  • make sure it’s fitted correctly every time so it covers your cervix - read more about how to use it

  • always use it with spermicide, and reapply spermicide if it’s been in place for more than 3 hours before you have sex

  • use extra spermicide every time you have more sex

  • make sure you do not remove it too soon (leave it at least 6 hours after the last time you had sex)

  • do not use oil-based products when handling your diaphragm (such as baby lotion, bath oils, moisturiser or some vaginal medicines like pessaries)

  • you can use diaphragms and condoms at the same time for added protection

If you forget any of these things, or you forget to use your diaphragm, you may need emergency contraception.

Did you know?

If you’re using natural family planning, the diaphragm can be a good alternative to condoms when you need protection on your most fertile days.

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